by Dave Anderson and Chipps
December 29, 2016
It’s not as glamorous as some nice shiny carbon, but one day it could be a good deal more useful. Dave and the crew get emergency first aid educated…
This article first appeared in issue 96 of Singletrack Magazine. Subscribers have full access to all Singletrack articles past and present. Learn more from about our subscriptions offers:
Picture this scene:
You’re riding along a trail when you watch the walker ahead of you topple to the right and drop to the floor. By the time you reach him, he’s dazed and replies to you in a confused voice; he doesn’t remember what happened, and he’s bleeding heavily from a deep gash that’s busy matting his hair. There’s no one else around. It’s just you, his dog and him. The dog isn’t going to be much use here; what are you going to do? How are you going to help him? And where and when are you going to get help to help you?
Forgetting the debate about who said it for a minute, let’s embrace the concept of ‘Knowledge is power’. It’s a pretty powerful statement that’s been knocking around for more than a little while, and I think it’s an important thing to accept when it comes to first aid, especially outdoors, and even more so in the mountains when you’re more than half an hour from help.
Dealing with an injured or ill mate, or anyone for that matter, will take on a whole new level of seriousness when help or rescue isn’t going to be immediately available. Ambulance response times? When you’re in a remote situation you can throw those out of the window, and you’ll be surprised by how quickly ‘a little bit off the beaten track’ becomes ‘remote’, in the eyes of your traditional first responders.
It’s in this situation that the pre-packaged first aid pack you bought ‘just in case’, and have carried religiously in your CamelBak for months or years, becomes somewhat less important than the knowledge of just what needs doing to keep your casualty from slipping any deeper into the shit than you find yourself already in. When it’s all down to you, and you’ve got 45 minutes minimum until someone turns up, there’s a whole load of issues that aren’t going to be addressed by a couple of plasters and some TLC.
I first got involved in first aid, like most folk I guess, through a First Aid at Work course that taught me the basics with a ‘patching up until the ambulance arrives’ mentality. It was a great introduction and gave me the confidence to deal with day-to-day accidents and injuries, but at the same time raised a lot of issues about how I could apply that approach in my work place – the outdoors – rather than an office. There’s a whole raft of difference between trying to help someone in the comfort of an office and halfway round the traditional trail centre loop. In the outdoors you’re rarely within reach of an ambulance; it’s more likely going to be mountain rescue you’re calling for, and that results in a somewhat longer response time than your First Aid at Work course allows for.
First aid outdoors requires a whole different approach. There’s a need to adapt to the situation, for more improvisation, and for a lot more self-reliance until help finally arrives. And this is precisely where that knowledge and the confidence it inspires will overshadow all the kit you could buy – because, when it comes down to it, anything that absorbs blood can be a bandage, and knowing a bit about what’s likely to happen to a casualty lying on an exposed hillside, and how you can prevent or reduce it, is what’s going to make you feel that you did everything possible to make things better after the event.
Welcome to the world of outdoor and mountain first aid.
There are a number of outdoor emergency first aid courses available in the UK, from a number of providers. They’re a similar mix of theory and practice you get on a Health and Safety (HSC) course, but they tend to be more practical, with an emphasis on practice outdoors, and focus much more on environmental considerations in caring for your casualty. There’s a more down-to-earth approach that reflects the variety of situations injuries can occur in and the lack of textbook scenarios they result in, the need to be flexible in how you approach each possible case, and prepares you for the fact you’re going to be in charge of what happens for longer until help arrives. At the end of a course you should feel confident to adapt to changeable situations and make calls you wouldn’t necessarily need to in the HSC world, all backed up by solid knowledge.
That knowledge – that you can deal with injury in a remote setting, that you are confident that you know what to do – is a good one to have. Trust me. Not sure you need it? Let’s deal with that word ‘remote’. Just what is remote? A day’s ride away from civilisation? Think more of 30 minutes by foot from the nearest ambulance, which isn’t very far at all given where we ride. If you’re away from a road you’re almost out of ambulance territory and into the realm of Mountain Rescue. Knowing who to ring first will make a massive difference in how quickly help arrives. It turns out that remote in the modern world isn’t really that remote at all.
With this in mind, combined with an upcoming Mountain Bike Leader course and a recently expired Mountain First Aid certificate on my part, we embarked on lining up a local course to get a few of us in the office fully qualified and ‘with the ticket’. As a few of us lead rides, even though it’s in that grey area of riding with mates, there was a general feeling it was better to have a qualification than not, and with the course only taking two days it’s hardly an arduous undertaking. If it’s not something you’ve previously considered, I’d recommend even a basic course, as in the event of something happening it’s better to know how to help rather than stand around helpless. I’ve experienced bad situations and knowing I did what I could made a big difference in how I felt and dealt with the shock that came afterwards (and that’s important too).
Settling on local Mountain Rescue team member and Rescue Emergency Care (REC) trainer, Richard, to teach us the basics, our course was delivered with a mix of indoor theory and outdoor practical sessions that encouraged us to start thinking about how to deliver care based on a series of real life situations. Learning CPR on good old Resusci Annie in a classroom with its nice flat floor is one thing, but doing it on a slope when you’ve got to disentangle her from her bike first is quite another.
Being able to tailor the course to any given outdoor sport and its typical injuries is one of the strengths of this type of training and its approach. When and how to remove a rider’s helmet, when and how do you move an unconscious patient, how do you make them feel more comfortable, how do you stop them deteriorating when it’s pissing down with rain – everything was covered and repeated until we all felt comfortable taking charge of the situations Richard presented to us.
It was refreshing to hear the real time expectations of just how long we can expect to have to deal with an injury before someone else turns up. Even the simple things like knowing how a call to the wrong service might extend that time helps make decisions earlier, which can have a big effect on the outcome of your situation; performing CPR for three minutes is hard, but for 30? It’s better to know just how long you may be there and plan accordingly.
We also covered management not just of the casualty but of the group we might possibly be part of, too. How to use those spare bodies to assist, go for help, keep us informed on what’s happening, and help keep the casualty protected from the elements. How to keep an eye on the situation, watch for worsening weather and be ready for shock in others which could complicate things considerably mean we’re treating multiple casualties instead of one.
In two days we covered multiple situations; similar injuries where treatment varies by where we are, where the environment we’re in dictates to a certain extent the approach initially taken. Is it safe to approach? Is it safe to treat in situ? Is there anything we’ve missed that will make things worse? Two days of intensive training, in real life scenarios, with real people, end with everyone feeling more confident about how they’ll approach the real thing should the worst happen.
It’s empowering to have that knowledge. By the end of the course I know I can deal with anything, through a mix of knowing both what to do and when there’s a need to adapt. I’m confident I will be able to cope, and more than that, I know I can take charge of the situation and make a difference until proper medical help arrives. And, perhaps just as importantly, I know how long that might be…
Although we spent time on the course learning how to improvise the kit we’d need to deal with a medical emergency with what we had to hand, we also learnt about what we should be carrying in our packs. So here’s a quick rundown of three useful first aid kits that will help us (and you) deal with any potential emergency – whether it occurs within a mile of the front door or half a day’s ride from rescue.
- Adhesive dressings
- (1) Adhesive tape
- (2) Ambulance/trauma dressing
- (3) Antiseptic wipes
- (4) Bandages, assorted sizes
- Blister/hydrocolloid plasters
- Chewable aspirin
- (5) Dressings, assorted sizes
- (6) Duct tape (wrap it around your pump)
- (7) Dry bag or ziplock freezer bag
- (8) Emergency bivvy or blizzard bag
- (9) Four-man shelter
- (10) Glowstick (for hilltop raving)
- (11) Micropore tape
- (12) Plasters
- (13) Resuscitation mask
- Saline eyewash
- (14) SAM splint
- Tick remover
- (15) Triangular bandage
- (16) Tuff cuts
- (17) Vinyl/nitrile gloves (in 35mm film canister)
- (18) Wound closure strips
- (19) Zinc oxide tape
We carried out our training with RCS Training & Consultancy